Hernia

A hernia happens when part of an internal organ or tissue bulges through a weak area of muscle. Most hernias are in the abdomen.

There are several types of hernias, including:

• Inguinal, in the groin. This is the the most common type.
• Umbilical, around the belly button
• Incisional, through a scar
• Hiatal, a small opening in the diaphragm that allows the upper part of the stomach to move up into the chest.
• Congenital diaphragmatic, a birth defect that needs surgery

Hernias are common. They can affect men, women, and children. A combination of muscle weakness and straining, such as with heavy lifting, might contribute. Some people are born with weak abdominal muscles and may be more likely to get a hernia.

Treatment is usually surgery to repair the opening in the muscle wall. Untreated hernias can cause pain and health problems.

Peritonitis

Peritonitis is an inflammation (irritation) of the peritoneum. This is the thin tissue that lines the inner wall of the abdomen and covers most of the abdominal organs.

Causes

Peritonitis is caused by a collection of blood, body fluids, or pus in the belly (abdomen).

One type is called spontaneous bacterial peritonitis (SPP). It occurs in people with ascites. Ascites is the buildup of fluid in the space between the lining of the abdomen and the organs. This problem is found in people with long-term liver damage, certain cancers, and heart failure.

Peritonitis may be a result of other problems. This is known as secondary peritonitis. Problems that may lead to this type of peritonitis include:

• Trauma or wounds to the belly
• Ruptured appendix
• Ruptured diverticula
• Infection after any surgery in the belly

Symptoms

The belly is very painful or tender. The pain may become worse when the belly is touched or when you move.

Your belly may look or feel bloated. This is called abdominal distention.

Other symptoms may include:

• Fever and chills
• Passing little or no stools or gas
• Excessive fatigue
• Passing less urine
• Nausea and vomiting
• Racing heartbeat
• Shortness of breath

Cholecystitis

Acute cholecystitis is sudden swelling and irritation of the gallbladder. It causes severe belly pain.

Causes

The gallbladder is an organ that sits below the liver. It stores bile, which is produced in the liver. Your body uses bile to digest fats in the small intestine.

Acute cholecystitis occurs when bile becomes trapped in the gallbladder. This often happens because a gallstone blocks the cystic duct, the tube through which bile travels into and out of the gallbladder. When a stone blocks this duct, bile builds up, causing irritation and pressure in the gallbladder. This can lead to swelling and infection.

Other causes include:

• Serious illnesses, such as HIV or diabetes
• Tumors of the gallbladder (rare)

Some people are more at risk for gallstones. Risk factors include:

• Being female
• Pregnancy
• Hormone therapy
• Older age
• Being Native American or Hispanic
• Obesity
• Losing or gaining weight rapidly
• Diabetes

Sometimes, the bile duct becomes blocked temporarily. When this occurs repeatedly, it can lead to long-term (chronic) cholecystitis. This is swelling and irritation that continues over time. Eventually, the gallbladder becomes thick and hard. It does not store and release bile as well as it did.

Symptoms

The main symptom is pain in the upper right side or upper middle of your belly that usually lasts at least 30 minutes. You may feel:

• Sharp, cramping, or dull pain
• Steady pain
• Pain that spreads to your back or below your right shoulder blade

Other symptoms that may occur include:

• Clay-colored stools
• Fever
• Nausea and vomiting
• Yellowing of skin and whites of the eyes (jaundice)

Gastroesophageal Reflux Disease (GERD)

Your esophagus is the tube that carries food from your mouth to your stomach. Gastroesophageal reflux disease (GERD) happens when a muscle at the end of your esophagus does not close properly. This allows stomach contents to leak back, or reflux, into the esophagus and irritate it.

You may feel a burning in the chest or throat called heartburn. Sometimes, you can taste stomach fluid in the back of the mouth. If you have these symptoms more than twice a week, you may have GERD. You can also have GERD without having heartburn. Your symptoms could include a dry cough, asthma symptoms, or trouble swallowing.

Anyone, including infants and children, can have GERD. If not treated, it can lead to more serious health problems. In some cases, you might need medicines or surgery. However, many people can improve their symptoms by:

• Avoiding alcohol and spicy, fatty or acidic foods that trigger heartburn
• Eating smaller meals
• Not eating close to bedtime
• Losing weight if needed
• Wearing loose-fitting clothes

Dissecting Thoracic Aortic Aneurysm

An aneurysm is a bulge or “ballooning” in the wall of an artery. Arteries are blood vessels that carry oxygen-rich blood from the heart to other parts of the body. If an aneurysm grows large, it can burst and cause dangerous bleeding or even death.

Most aneurysms are in the aorta, the main artery that runs from the heart through the chest and abdomen.

There are two types of aortic aneurysm:

• Thoracic aortic aneurysms (TAA) – these occur in the part of the aorta running through the chest
• Abdominal aortic aneurysms (AAA) – these occur in the part of the aorta running through the abdomen

Most aneurysms are found during tests done for other reasons. Some people are at high risk for aneurysms. It is important for them to get screening, because aneurysms can develop and become large before causing any symptoms. Screening is recommended for people between the ages of 65 and 75 if they have a family history, or if they are men who have smoked. Doctors use imaging tests to find aneurysms. Medicines and surgery are the two main treatments.

Hemorrhoids

Hemorrhoids are swollen, inflamed veins around your anus or the lower part of your rectum. There are two types:

• External hemorrhoids, which form under the skin around your anus
• Internal hemorrhoids, which form in the lining of your anus and lower rectum

What causes hemorrhoids?

Hemorrhoids happen when there is too much pressure on the veins around the anus. This can be caused by:

• Straining during bowel movements
• Sitting on the toilet for long periods of time
• Chronic constipation or diarrhea
• A low-fiber diet
• Weakening of the supporting tissues in your anus and rectum. This can happen with aging and pregnancy.
• Frequently lifting heavy objects

What are the symptoms of hemorrhoids?

The symptoms of hemorrhoids depend on which type you have:

With external hemorrhoids, you may have:

• Anal itching
• One or more hard, tender lumps near your anus
• Anal pain, especially when sitting

Too much straining, rubbing, or cleaning around your anus may make your symptoms worse. For many people, the symptoms of external hemorrhoids go away within a few days.

With internal hemorrhoids, you may have:

• Bleeding from your rectum – you would see bright red blood in your stool, on toilet paper, or in the toilet bowl after a bowel movement
• Prolapse, which is a hemorrhoid that has fallen through your anal opening

Internal hemorrhoids are usually not painful unless they are prolapsed. Prolapsed internal hemorrhoids may cause pain and discomfort.

Upper GI Bleed

Gastrointestinal (GI) bleeding refers to any bleeding that starts in the gastrointestinal tract.

Bleeding may come from any site along the GI tract, but is often divided into:

• Upper GI bleeding: The upper GI tract includes the esophagus (the tube from the mouth to the stomach), stomach, and first part of the small intestine.
• Lower GI bleeding: The lower GI tract includes much of the small intestine, large intestine or bowels, rectum, and anus.

Considerations

The amount of GI bleeding may be so small that it can only be detected on a lab test, such as the fecal occult blood test. Other signs of GI bleeding include:

• Dark, tarry stools
• Larger amounts of blood passed from the rectum
• Small amounts of blood in the toilet bowl, on toilet paper, or in streaks on stool (feces)
• Vomiting blood

Massive bleeding from the GI tract can be dangerous. However, even very small amounts of bleeding that occur over a long period of time can lead to problems such as anemia or low blood counts.

Once a bleeding site is found, many therapies are available to stop the bleeding or treat the cause.

Causes

GI bleeding may also be a sign of more serious diseases and conditions. These may include cancers of the GI tract, such as:

• Cancer of the colon
• Cancer of the small intestine
• Cancer of the stomach
• Intestinal polyps (a pre-cancerous condition)

Other causes of GI bleeding may include:

• Abnormal blood vessels in the lining of the intestines (also called angiodysplasia)
• Bleeding diverticulum, or diverticulosis
• Crohn disease or ulcerative colitis
• Esophageal varices
• Esophagitis
• Gastric (stomach) ulcer
• Intussusception (bowel telescoped on itself)
• Mallory-Weiss tear
• Meckel diverticulum
• Radiation injury to the bowel

Esophageal Varices

The esophagus (food pipe) is the tube that connects your throat to your stomach. Varices are enlarged veins that may be found in the esophagus in people with cirrhosis of the liver. These veins may rupture and bleed.

Causes

Scarring (cirrhosis) of the liver is the most common cause of esophageal varices. This scarring cuts down on blood flowing through the liver. As a result, more blood flows through the veins of the esophagus.

The extra blood flow causes the veins in the esophagus to balloon outward. Heavy bleeding can occur if the veins tear.

Any type of long-term (chronic) liver disease can cause esophageal varices.

Varices can also occur in the upper part of the stomach.

Symptoms

People with chronic liver disease and esophageal varices may have no symptoms.

If there is only a small amount of bleeding, the only symptom may be dark or black streaks in the stools.

If larger amounts of bleeding occur, symptoms may include:

• Black, tarry stools
• Bloody stools
• Lightheadedness
• Paleness
• Symptoms of chronic liver disease
• Vomiting blood

Peptic Ulcer

A peptic ulcer is a sore in the lining of your stomach or your duodenum, the first part of your small intestine. A burning stomach pain is the most common symptom. The pain:

• Starts between meals or during the night
• Briefly stops if you eat or take antacids
• Lasts for minutes to hours
• Comes and goes for several days or weeks

Peptic ulcers happen when the acids that help you digest food damage the walls of the stomach or duodenum. The most common cause is infection with a bacterium called Helicobacter pylori. Another cause is the long-term use of nonsteroidal anti-inflammatory medicines (NSAIDs) such as aspirin and ibuprofen. Stress and spicy foods do not cause ulcers, but can make them worse.

To see if you have an H. pylori infection, your doctor will test your blood, breath, or stool. Your doctor also may look inside your stomach and duodenum by doing an endoscopy or x-ray.

Peptic ulcers will get worse if not treated. Treatment may include medicines to reduce stomach acids or antibiotics to kill H. pylori. Antacids and milk can’t heal peptic ulcers. Not smoking and avoiding alcohol can help. You may need surgery if your ulcers don’t heal.

Hepatitis

Hepatitis is inflammation of the liver. Inflammation is swelling that happens when tissues of the body are injured or infected. It can damage your liver. This swelling and damage can affect how well your liver functions.

Hepatitis can be an acute (short-term) infection or a chronic (long-term) infection. Some types of hepatitis cause only acute infections. Other types can cause both acute and chronic infections.

What causes hepatitis?

There are different types of hepatitis, with different causes:

• Viral hepatitis is the most common type. It is caused by one of several viruses — hepatitis viruses A, B, C, D, and E. In the United States, A, B, and C are the most common.
• Alcoholic hepatitis is caused by heavy alcohol use
• Toxic hepatitis can be caused by certain poisons, chemicals, medicines, or supplements
• Autoimmune hepatitis is a chronic type in which your body’s immune system attacks your liver. The cause is not known, but genetics and your environment may play a role.

How is viral hepatitis spread?

Hepatitis A and hepatitis E usually spread through contact with food or water that was contaminated with an infected person’s stool. You can also get hepatitis E by eating undercooked pork, deer, or shellfish.

Hepatitis B, hepatitis C, and hepatitis D spread through contact with the blood of someone who has the disease. Hepatitis B and D may also spread through contact with other body fluids. This can happen in many ways, such as sharing drug needles or having unprotected sex.

Who is at risk for hepatitis?

The risks are different for the different types of hepatitis. For example, with most of the viral types, your risk is higher if you have unprotected sex. People who drink a lot over long periods of time are at risk for alcoholic hepatitis.

What are the symptoms of hepatitis?

Some people with hepatitis do not have symptoms and do not know they are infected. If you do have symptoms, they may include:

• Fever
• Fatigue
• Loss of appetite
• Nausea and/or vomiting
• Abdominal pain
• Dark urine
• Clay-colored bowel movements
• Joint pain
• Jaundice, yellowing of your skin and eyes

If you have an acute infection, your symptoms can start anywhere between 2 weeks to 6 months after you got infected. If you have a chronic infection, you may not have symptoms until many years later.

Appendicitis

The appendix is a small, tube-like organ attached to the first part of the large intestine. It is located in the lower right part of the abdomen. It has no known function. A blockage inside of the appendix causes appendicitis. The blockage leads to increased pressure, problems with blood flow, and inflammation. If the blockage is not treated, the appendix can burst and spread infection into the abdomen. This causes a condition called peritonitis.

The main symptom is pain in the abdomen, often on the right side. It is usually sudden and gets worse over time. Other symptoms may include:

• Swelling in the abdomen
• Loss of appetite
• Nausea and vomiting
• Constipation or diarrhea
• Inability to pass gas
• Low fever

Not everyone with appendicitis has all these symptoms.

Appendicitis is a medical emergency. Treatment almost always involves removing the appendix. Anyone can get appendicitis, but it is more common among people 10 to 30 years old.